AccountId: 011433970860
ContactId: e3ddb466-8580-4615-9d94-3b9d43b886ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192770 ms
Total Talk Time (AGENT): 82006 ms
Total Talk Time (CUSTOMER): 51893 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/e3ddb466-8580-4615-9d94-3b9d43b886ad_20250620T13:45_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from the dermatologist's office. I wanna verify a patient's eligibility.
[AGENT][POSITIVE] OK. Well, I can definitely help you with the eligibility. May I have your name?
[CUSTOMER][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][POSITIVE] OK cool.
[AGENT][POSITIVE] Thank you for that and the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Let me go into this chart.
[CUSTOMER][NEUTRAL] 01893413 ML 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] OK, um, do you guys cover copayments?
[AGENT][NEUTRAL] Um, hold on, let me see what type of policy this is.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] So this is the Metlink supplemental insurance. So yes, we pay towards the copay, deductible and co-insurance of coverage charges after primary.
[CUSTOMER][NEUTRAL] OK, so you guys cover everything after primary.
[AGENT][NEUTRAL] Of coverage charges. So the secondary policy has its own coverage as well. Are you you're considered outpatient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, so we would pay up to $500 per calendar year. Um, did you want me to see if any of that has been used?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and none of the benefits have been used for [PII], so she still has that full 500 for the year.
[CUSTOMER][NEUTRAL] OK, um, can I have a reference number please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date, and again, that's [PII], first initial of my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much for your help.
[AGENT][NEUTRAL] You're welcome, sir right. And again, all the information provided was a verification of benefits, not a guarantee of payment. Thank you for calling APL. I hope you have a great weekend.
[CUSTOMER][POSITIVE] Thank you, you too.
[AGENT][POSITIVE] Thank you. Bye-bye.